The journal, edited by the Department of Social Medicine at the University of Bristol, reprints a key paper from the 1950s on stress and heart disease and assesses how our understanding of the possible effect of stress on health has changed during the last 50 years.

This paper and other research published in the journal show that even though people intuitively feel that stress is an important factor in influencing well being, scientifically the evidence of a link between stress and ill-health is still very thin.

When Dr IMcDG Stewart published his groundbreaking paper Coronary disease and modern stress in The Lancet in 1950, stress was commonly thought to be a major cause of heart disease. He suggested that educated professional males were the usual victims of stress, that women's only source of stress was the prospect of too many pregnancies and that manual labourers had "no inclination towards self-betterment" and were therefore safe from the tyranny of stress.

While Dr Stewart's views highlight how much social attitudes have changed, the debate about the relationship between stress and health still continues to rage.

We now have sound evidence that heart disease is more prevalent among those working in manual occupations and that it is also related to diet, smoking and physical activity. However, evidence of the role played by 'stress' is still unclear.

Although some research has suggested that psychosocial factors such as hostility, depressive illness and the quality of social relations are related to heart disease, these are simply factors experienced more by poorer people who have higher rates of heart disease for other reasons.

New research reported in the journal shows that several currently fashionable stress factors - including low control over work, social support and neuroticism - are not important causes of heart disease and general ill-health.

It shows that certain factors can artificially generate associations between stress and health and that the concept of what constitutes "stress" may sometimes be changed to fit in with the current distribution of heart disease.

The International Journal of Epidemiology is a key journal in the field of epidemiology and public health, published six times per year by Oxford University Press. It is edited at the Department of Social Medicine, University of Bristol, which is a leading centre for epidemiology, health services research and public health in the UK and was one of only three to be awarded the top 5* grade in the 2001 Research Assessment Exercise.